Leveraging MLTSS to Accomplish System Objectives
|
|
- Maud May
- 5 years ago
- Views:
Transcription
1 Leveraging MLTSS to Accomplish System Objectives
2 Leveraging MLTSS to Accomplish System Objectives Paul Saucier Truven Health Analytics Inc. All Rights Reserved. 2
3 What are States Objectives for MLTSS? System Balance Increase HCBS options Improve nursing home diversion/transition Access Reduce HCBS waiting lists Increase primary care, dental, transportation Better Experience Better Outcomes Person-centered coordination across settings and services Better chronic care management Health and function Independence and community inclusion Lower Costs Lower growth in per-person costs Better budget predictability Truven Health Analytics Inc. All Rights Reserved. 3
4 What levers does MLTSS provide? Accountable Entity Reporting Performance Measures Performance Incentives Rate Setting Methods Sanctions Truven Health Analytics Inc. All Rights Reserved. 4
5 Leveraging Managed Long-Term Services and Supports to Accomplish System Objectives Kari Bruffett, Secretary Aquila Jordan, HCBS Program Director Kansas Department for Aging and Disability Services 5
6 Before MLTSS Kansas Medicaid and CHIP had used managed care models for children and families since the 1990s. But Kansas Medicaid historically was not outcomes-oriented overall. The most complex consumers were in the fee-for-service model, with services defined by the programs they were in. Fueled by fragmentation, costs rose at an annual rate of 7.4 percent over the decade of the 2000s. In Old Medicaid, budget concerns would trigger rate reductions and create waiting lists for certain services. 6
7 Introducing MLTSS in Kansas Kansas developed KanCare, a coordinated managed care program for nearly all beneficiaries and services. A centerpiece of KanCare, which launched in 2013, was integrating managed long term services and supports (MLTSS) with physical and behavioral health. After an initial 13-month delay of the inclusion of MLTSS for members with intellectual or developmental disabilities (ID/DD), now all HCBS services are included in managed care. 7
8 Goals for MLTSS Improve quality Integration of care, including health outcomes Access To HCBS To physical health services To BH services Person-centeredness Enable independence Avoidance of unnecessary institutionalization Successful transitions back to the community Competitive employment 8
9 MLTSS Tools Blended Long Term Care rate cells Same capitated rate for members whether in SNFs or physical disability and frail elderly waivers Pay for Performance and other measures related to HCBS members Integration of risk for services regardless of setting including NF and other institutions Comprehensive care management MCO contracting flexibility/ability to expand networks Addresses potential conflicts in legacy system Support for self-direction in the MLTSS model 9
10 Challenges/Opportunities SNF beneficiary counts have declined, but modestly. Many members only become eligible for Medicaid/KanCare after they are already in a SNF Waiting lists IMD Exclusion Administrative challenges of using in lieu of services to reach outside of specific 1915(c) waiver services Through first 6 months of CY 2015, MCOs had provided more than $1 million of in lieu of services to > 600 members. Better health outcomes (lower ED utilization, more access to primary care), but continued service siloes 10
11 Next Steps Strengthening contract provisions related to key program outcomes Encouraging more quality-based contracting models with service providers Expanding employment programs through pending 1115 amendment Preparing for 1115 amendment to integrate all HCBS waiver services, removing siloes that limit access to services based upon program eligibility 11
12 STATE OF TENNESSEE Leveraging MLTSS to Accomplish System Objectives September 1, 2015 HCBS Conference 12
13 MLTSS in Tennessee Managed care demonstration implemented in 1994 Operates under the authority of an 1115 waiver Entire Medicaid population (1.4 million) in managed care 3 at-risk NCQA accredited MCOs (statewide in 2015) Physical/behavioral health integrated beginning in 2007 LTSS for seniors and adults w/ physical disabilities in 2010 MLTSS program is called CHOICES ICF/IID and 1915(c) ID waivers carved out; populations carved in New proposed MLTSS program component for I/DD for 2016: Employment and Community First CHOICES 13
14 Key Objectives of the CHOICES Program Improve coordination and quality of care (Access) Expand access to HCBS (Lower Costs) Utilize existing LTSS funds to serve more people Reduce/eliminate waiting list Rebalance system (System Balance) Increase HCBS utilization Delay/prevent NF placement) 14
15 Aligning the Incentives Improve coordination and quality of care Integration of benefits (physical and behavioral health and LTSS, including NF and HCBS) Single accountable entity Detailed care coordination requirements including performance measures, reporting and sanctions Expand access to HCBS/rebalance system Blended capitation payment for NF eligible population Rate setting methods MFP performance incentives for transition and sustained community living, as well as system benchmarks % HCBS vs. NF expenditures, consumer direction participation, community based residential alternative development 15
16 Access to HCBS before and after Global budget approach: HCBS Enrollment* 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Expanded access to HCBS subject to new appropriations 0 1,131 4,861 13,409 HCBS enrollment without CHOICES 6,000 Limited LTC funding spent based on needs and preferences of those who need care More cost-effective HCBS serves more people with existing LTC funds Critical as population ages and demand for LTC increases No state-wide HCBS alternative to NFs available before CMS approves HCBS waiver and enrollment begins in Slow growth in HCBS enrollment reaches 1,131 after two years. * Excludes the PACE program which serves 325 people almost exclusively in HCBS, and other limited waiver programs no longer in operation. HCBS enrollment at CHOICES implementation Well over twice as many people who qualify for nursing facility care receive cost-effective HCBS without a program expansion request; additional cost of NF services if HCBS not available approx. $250 million (federal and state). HCBS waiting list eliminated in CHOICES 16
17 Re-balancing LTSS Enrollment through the CHOICES Program LTSS Enrollment before CHOICES Program (March/August 2010) HCBS 17% LTSS Enrollment as of August 1, 2015 HCBS 44% NF 83% NF 57% Nursing Facility Enrollment HCBS Enrollment 90% 90% 70% 70% 50% 50% 30% 30% 10% 10% 17
18 Expanding Key System Objectives in CHOICES Better Experience/Better Outcomes Contract requirements regarding person-centered planning/supports, employment and community integration Invest in building health plan and provider capacity for person-centered planning and support delivery, employment and community integration Implement annual Individual Experience Assessment Leverage technology to gather point-of-service member satisfaction data with in-home HCBS Participate in National Core Indicators AD to compare program and health plan performance Engage in system-wide payment reform to align payment with value Primary care transformation Episodes of care LTSS 18
19 Aligning incentives through integrated service delivery, benefit design, payment New Behavioral Health Crisis Prevention, Intervention and Stabilization services and Model of Support Delivered under managed care program, in collaboration with I/DD agency Focus on crisis prevention and in-home stabilization, sustained community living, reduced inpatient utilization Performance measures (e.g., decrease in PRN use of antipsychotics, decrease in crisis events, increase in in-place stabilization when crises occur, and decrease in inpatient psychiatric admissions and inpatient days) will be tracked and utilized to establish a VBP component (incentive or shared savings) for the reimbursement structure 19
20 Aligning incentives through integrated service delivery, benefit design, payment Employment and Community First CHOICES New MLTSS program component to be implemented in 2016 Promotes integrated employment and community living as the first and preferred outcome for individuals with I/DD Outcome-based reimbursement for certain employment services Reimbursement approach for other services will take into account provider s performance on key outcomes, including number of persons employed in integrated settings and # of hours of employment (after a reasonable period for data collection and benchmarking) 20
21 THANK YOU Patti Killingsworth Assistant Commissioner/Chief of LTSS TennCare MCO contract available at: nncare/attachments/mcostatewide Contract.pdf 21
22 Managed Care Long Term Services and Supports in Texas Gary Jessee, Chief Deputy Director for Program Operations Medicaid and CHIP Division Texas Health and Human Services Commission
23 MLTSS in Texas About 86% of Texas Medicaid beneficiaries are served through managed care About 578,000 in STAR+PLUS Recent Legislative Direction Eliminate interest list for SSI recipients for HCBS STAR+PLUS Waiver Carve in all behavioral health services Carve in supported employment and employment assistance Carve in nursing facility services Page 23
24 Service Coordination MLTSS in Texas MCO employees provide specialized case management Amount of service coordination delivered is based on a member s need Changes were made to service coordination structure based on feedback obtained through quality activities Rebalancing Efforts Money Follows the Person Demonstration Participation in Community Transition Team meetings MCO service coordinators as a no wrong door Page 24
25 Nursing Facility Quality Initiatives MLTSS Quality Initiatives Nursing Facility Carve-in Quality Program Quality Incentive Payment Program Dual Eligible Integrated Care Demonstration Shared Savings Program Community MLTSS Creation of MLTSS performance measures Participating in the National Core Indicators-Aging and Disabilities survey initiative Page 25
26 Kari Bruffett Aquila Jordan Gary Jessee Thank You! Patti Killingsworth Paul Saucier
The Changing Role of States in Long-Term Services and Supports
The Changing Role of States in Long-Term Services and Supports TennCare Overview Tennessee s Medicaid Agency Tennessee s Medicaid Program Managed care demonstration implemented in 1994 Operates under the
More informationTransforming Louisiana s Long Term Care Supports and Services System. Initial Program Concept
Transforming Louisiana s Long Term Care Supports and Services System Initial Program Concept August 30, 2013 Transforming Louisiana s Long Term Care Supports and Services System Our Vision Introduction
More informationSunflower Health Plan
Key Components for Successful LTSS Integration: Case Studies of Ten Exemplar Programs Sunflower Health Plan Jennifer Windh September 2016 Long- term services and supports (LTSS) integration is the integration
More informationFor Profit Managed Care for Long Term Supports & Services Lessons Learned
For Profit Managed Care for Long Term Supports & Services Lessons Learned Mike Chittenden, The Arc Nebraska Kevin Fish, The Arc of Sedgwick County Carrie Hobbs Guiden, The Arc Tennessee John Nash, The
More informationMedicaid and CHIP Managed Care Final Rule MLTSS
Medicaid and CHIP Managed Care Final Rule MLTSS John Giles, Technical Director Division of Quality and Health Outcomes Children and Adult Health Programs Group Debbie Anderson, Deputy Director Division
More informationStrengthening Long Term Services and Supports (LTSS): Reform Strategies for States
Advancing innovations in health care delivery for low-income Americans Strengthening Long Term Services and Supports (LTSS): Reform Strategies for States March 6, 2018 Michelle Herman Soper and Alexandra
More informationProtecting the Rights of Low-Income Older Adults
Protecting the Rights of Low-Income Older Adults November 17, 2014 Consumer Rights in Medicaid MLTSS Advocating for choice, protection and quality Gwen Orlowski, National Senior Citizens Law Center www.nsclc.org
More informationRate-Setting Strategies to Advance Medicaid Managed Long-Term Services and Supports Goals: State Insights
Rate-Setting Strategies to Advance Medicaid Managed Long-Term Services and Supports Goals: State Insights Tuesday, August 16, 2016 1:00-2:30 pm ET Made possible by the West Health Policy Center www.chcs.org
More informationDiamond State Health Plan Plus
I N T E G R A T E D L O N G T E R M Diamond State Health Plan Plus DSHP-Plus C A R E 1115 Demonstration Waiver Diamond State Health Plan (DSHP) Managed Care Delivery System Operational since January 1996
More informationMEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN
Louisiana Behavioral Health Partnership MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN Rosanne Mahaney - Delaware Lou Ann Owen - Louisiana Brenda Jackson,
More informationTennessee s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model
Tennessee s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model In 2011, Tennessee was awarded a federal Money Follows the Person (MFP) grant,
More informationAetna Medicaid. Special Needs Plans. What Works; What Doesn t
Aetna Medicaid Special Needs Plans. What Works; What Doesn t Topics Aetna Medicaid Overview Special Needs Plan (SNP) Overview Mercy Care experience as Medicare Advantage Dual SNP and ALTCS Medicaid MCO
More informationRE: Centers for Medicare & Medicaid Services: Innovation Center New Direction Request for Information (RFI)
November 20, 2017 Ms. Seema Verma Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Ms. Amy Bassano Director Center
More informationHeather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care
Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care 1 2 Total Medicaid and CHIP population- 235,000 Currently approximately
More informationOpportunities to Advance Lifespan Respite: Managed Long-Term Services and Supports and Affordable Care Act Options
Opportunities to Advance Lifespan Respite: Managed Long-Term Services and Supports and Affordable Care Act Options October 18, 2013 Joe Caldwell Director of Long-Term Services and Supports Policy 1 Overview
More informationMLTSS PROGRAMS: SHARING DESIGN AND IMPLEMENTATION EXPERIENCES AUGUST 29, 2017
MLTSS PROGRAMS: SHARING DESIGN AND IMPLEMENTATION EXPERIENCES AUGUST 29, 2017 Deidra B. Abbott, MPH Kim Donica, Principal Bob Karsten, ASA, MAAA Mercer Angela Medrano New Mexico Human Services Department
More informationA Snapshot of Uniform Assessment Practices in Managed Long Term Services and Supports
A Snapshot of Uniform Assessment Practices in Managed Long Term Services and Supports California Department of Health Care Services, Home and Community Based Services Universal Assessment Workgroup February
More informationSelect Topics in Implementing an Integrated Medicaid Managed Long-Term Care Program
Select Topics in Implementing an Integrated Medicaid Managed Long-Term Care Program TennCare Overview Tennessee s Medicaid Agency Tennessee s Medicaid Program Managed care demonstration implemented in
More informationA Snapshot of the Connecticut LTSS Rebalancing Agenda
A Snapshot of the Connecticut LTSS Rebalancing Agenda Agenda Medicaid context and vision State Rebalancing Plan Major elements of rebalancing agenda Money Follows the Person, Nursing Home Rightsizing,
More informationSupporting MLTSS Consumers through Problem Resolution and Advocacy
Supporting MLTSS Consumers through Problem Resolution and Advocacy James David Toews, Becky A. Kurtz, Eliza Bangit September 11, 2013 Risks of Managed Long-Term Services and Supports (MLTSS) Many managed
More informationTrends in Medicaid Long-Term Services and Supports: A Move to Accountable Managed Care
National Committee for Quality Assurance in Collaboration with Health Management Associates Trends in Medicaid Long-Term Services and Supports: A Move to Accountable Managed Care Key Takeaways: Delivery
More informationMedicaid Experts 11/10/2015. Alphabet Soup. Medicaid: Overview and Innovations PPO HMO CMS CDC ACO ICF/MR MR/DD JCAHO LTC PPACA HRSA MRSA FQHC AMA AHA
Medicaid Experts DEVELOPING NEW STATE LEGISLATIVE HEALTH LEADERS Medicaid: Overview and Innovations While I can explain the meaning of life, I don t dare try to explain how the Medicaid system works. CMS
More informationNJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal
NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal Strengthening Medicaid: Alignment & Redesign Through Integration NJ Department of Human Services 1/6/2017 Table of Contents Executive
More informationMedicaid Managed Care. Long-term Services and Supports Trends
Medicaid Managed Care Long-term Services and Supports Trends Medicaid Managed Care Statistics As of 2011, 74.2% of Medicaid Enrollees were enrolled in a Medicaid Managed Care system As of 2011, California,
More informationManaged Long-Term Care in New Jersey
Managed Long-Term Care in New Jersey April 2009 Jon S. Corzine Governor Heather Howard Commissioner Introduction New Jersey s Fiscal Year 2009 Budget included the following language: On or before April
More informationNew Opportunities in Long Term Services and Supports
Profiles of State Innovation: Long -Term Supports and Services CHCS Webinar November 22, 1010 New Opportunities in Long Term Services and Supports Mary Sowers Director, Division of Community and Institutional
More informationLTSS INNOVATIONS IN THE CURRENT ENVIRONMENT
NASDDDS National Association of State Directors of Developmental Disabilities Services LTSS INNOVATIONS IN THE CURRENT ENVIRONMENT March 8, 2018 INTRODUCTIONS Barbara Selter Sharon Lewis Camille Dobson
More informationAlaska Mental Health Trust Authority. Medicaid
Alaska Mental Health Trust Authority Medicaid November 20, 2014 Background Why focus on Medicaid? Trust result desired in working on Medicaid policy issues and in implementing several of our focus area
More informationLong-Term Care Improvements under the Affordable Care Act (ACA)
Long-Term Care Improvements under the Affordable Care Act (ACA) South Carolina Health Care Implementation Coalition September 17, 2010 JoAnn Lamphere, DrPH Director, State Government Relations Health &
More informationCOMMONWEALTH COORDINATED CARE PLUS. A Managed Long Term Services and Supports Program
COMMONWEALTH COORDINATED CARE PLUS A Managed Long Term Services and Supports Program Agenda Background and Key Facts Populations Services Regional Launch CCC Plus Enrollment 2 Overview of Commonwealth
More informationNorth Carolina s Transformation to Managed Care
North Carolina s Transformation to Managed Care Jay Ludlam, Assistant Secretary Department of Health and Human Services December 2017 My background Only 10+ years of experience in Medicaid Assistant Attorney
More informationprograms and briefly describes North Carolina Medicaid s preliminary
State Experiences with Managed Long-term Care in Medicaid* Brian Burwell Vice President, Chronic Care and Disability Medstat Abstract: Across the country, state Medicaid programs are expressing renewed
More informationVIRGINIA S MEDICARE AND MEDICAID INTEGRATION EXPERIENCE 12/2/2016
VIRGINIA S MEDICARE AND MEDICAID INTEGRATION EXPERIENCE The Honorable Dr. William Hazel Secretary of Health and Human Resources Commonwealth of Virginia Why Is It Important to Integrate Medicare and Medicaid
More informationManaged Care Organization Program Coordination: An Opportunity for a Collaborative Approach
THE ILLINOIS MONEY FOLLOWS THE PERSON PROGRAM PATHWAYS TO COMMUNITY LIVING Managed Care Organization Program Coordination: An Opportunity for a Collaborative Approach January 9, 2015 RE-BALANCING IN ILLINOIS
More informationNC TIDE SPRING CONFERENCE April 26, NC Department of Health and Human Services Medicaid Transformation and the 1115 Waiver
NC TIDE SPRING CONFERENCE April 26, 2017 NC Department of Health and Human Services Medicaid Transformation and the 1115 Waiver Agenda Medicaid Landscape NC Medicaid Transformation Supporting Legislation
More informationLong-Term Services and Supports Study Committee: Person-Centered Medicaid Managed Care
Long-Term Services and Supports Study Committee: Person-Centered Medicaid Managed Care Barbara R. Sears, Director Ohio Department of Medicaid July 12, 2018 1 Health Care System Choices Fee-for-Service
More informationStatewide Medicaid Managed Care Long-term Care Program
Statewide Medicaid Managed Care Long-term Care Program Justin Senior Deputy Secretary for Medicaid Agency for Health Care Administration July 25, 2013 Presentation Overview Current Medicaid Snapshot and
More information10/3/2014. Ohio Department of Medicaid
Ohio Health Care Association Fall 2014 John McCarthy Medicaid Director Balancing Ohio: More Opportunities in the Community 2 1 Balancing Incentive Program (BIP) Background The Jobs Budget(2011) set out
More informationOptions for Integrating Care for Dual Eligible Beneficiaries
CHCS Center for Health Care Strategies, Inc. Technical Assistance Brief Options for Integrating Care for Dual Eligible Beneficiaries By Melanie Bella and Lindsay Palmer-Barnette, Center for Health Care
More informationUPDATE ON MANAGED CARE IN NY STATE: IMPLICATIONS FOR PROVIDERS
UPDATE ON MANAGED CARE IN NY STATE: IMPLICATIONS FOR PROVIDERS November 18, 2013 NYS OMH Behavioral Health Transition 2 Key MRT initiative to move fee-for-service populations and services into managed
More informationHCBS-AMH General Program FAQ's
General Program FAQ's HCBS-AMH 1. Why was the decision made to do a State Plan Amendment 1915(i) rather than a 1915(c) Medicaid waiver? The decision to seek a SPA rather than a waiver was made because
More informationMedicaid Managed LTSS: Great Opportunities, Big Risks
Medicaid Managed LTSS: Great Opportunities, Big Risks National Health Policy Forum May 11, 2012 Gordon Bonnyman Tennessee Justice Center gbonnyman@tnjustice.org 1 The Tennessee Context Tennessee has mandatorily
More informationLessons Learned from MLTSS Implementation in Florida Where Have We Been and Where Are We Going?
Lessons Learned from MLTSS Implementation in Florida Where Have We Been and Where Are We Going? David Rogers Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration 2016
More informationFrom Fragmentation to Integration: Bringing Medical Care and HCBS Together. Jessica Briefer French Senior Research Scientist
From Fragmentation to Integration: Bringing Medical Care and HCBS Together Jessica Briefer French Senior Research Scientist 1 Integration: The Holy Grail? An act or instance of combining into an integral
More informationThe Patient Protection and Affordable Care Act (Public Law )
Policy Brief No. 2 March 2010 A Summary of the Patient Protection and Affordable Care Act (P.L. 111-148) and Modifications by the On March 23, 2010, President Obama signed into law the Patient Protection
More informationNew York Children s Health and Behavioral Health Benefits
New York Children s Health and Behavioral Health Benefits DRAFT Transition Plan for the Children s Medicaid System Transformation August 15, 2017 DRAFT Transition Plan for the Children s Medicaid System
More informationCalifornia s Coordinated Care Initiative
California s Coordinated Care Initiative Sarah Arnquist Harbage Consulting Presentation on 4/22/13 2 Overview Federal and State Movement toward Coordinated Care Update on California s Coordinated Care
More informationMedicaid Transformation Overview & Update. Kelly Crosbie, MSW, LCSW Project Lead Quality & Population Health Division of Health Benefits
Medicaid Transformation Overview & Update Kelly Crosbie, MSW, LCSW Project Lead Quality & Population Health Division of Health Benefits IOM Policy Fellows: February 26, 2018 North Carolina s Vision for
More informationManaging Medicaid s Costliest Members
Managing Medicaid s Costliest Members White Paper January 2018 LTSS / MLTSS / HCBS: Issues & Guiding Principles for State Medicaid Programs Table of Contents Executive Summary... 3 LTSS: The Basics...
More informationDECODING THE JIGSAW PUZZLE OF HEALTHCARE
DECODING THE JIGSAW PUZZLE OF HEALTHCARE HPCANYS Leadership Institute November 6, 2015 Carla R. Williams, MPA Director, O Connell & Aronowitz Healthcare Consulting Group WHAT IS GOING ON? ENVIRONMENT ACA
More informationImproving the Continuum of Care: Progress on Selected Provisions of the Affordable Care Act One Year Post-Passage
Improving the Continuum of Care: Progress on Selected Provisions of the Affordable Care Act One Year Post-Passage March 23, 2011 marks the oneyear anniversary of the signing of the Patient Protection and
More informationOverview for HCBS. August 31, 2016
Overview for HCBS August 31, 2016 What is NCI-AD? Officially launched June 1, 2015 Quality of life survey for older adults and adults with physical disabilities Assesses state LTSS systems SNFs/Nursing
More informationMedicaid Transformation
JOINT LEGISLATIVE COMMITTEE ON MEDICAID AND NC HEALTH CHOICE Medicaid Transformation Dr. Mandy Cohen, Dave Richard, Jay Ludlam Department of Health and Human Services Nov. 14, 2017 Recap: Where We Are
More informationNew Delivery Systems for Long Term Services and Supports: How States are Diving into Affordable Care Act Opportunities
New Delivery Systems for Long Term Services and Supports: How States are Diving into Affordable Care Act Opportunities September 2013 Sarah Barth, JD, Director of Coverage and Access Michelle Herman Soper,
More informationManaged Long Term Services and Supports (MLTSS) A Forum for Consumers, their Families and Caregivers, Advocates and Community-Based Agencies
Managed Long Term Services and Supports (MLTSS) A Forum for Consumers, their Families and Caregivers, Advocates and Community-Based Agencies 1 Background To give you an update on the implementation of
More informationTennessee Health Care Innovation Initiative
Tennessee Health Care Innovation Initiative More information available at: http://www.tn.gov/hcfa/strategic.shtml State Innovation Model grant 2 1 State Innovation Model (SIM) funding Last week the Centers
More informationOlder Adult Services Act
State of Illinois Illinois Department on Aging Older Adult Services Act (P. A. 093-1031) 2017 Report To The General Assembly Message from Acting Director Jean Bohnhoff To The Honorable Members of the
More informationRequest for an Amendment to a 1915(c) Home and Community-Based Services Waiver
Page 1 of 11 Request for an Amendment to a 1915(c) Home and Community-Based Services Waiver 1. Request Information A. The State of North Carolina requests approval for an amendment to the following Medicaid
More informationMedicaid Reform: The Opportunities for Home and Community Based Providers. All Rights Reserved
Medicaid Reform: The Opportunities for Home and Community Based Providers ILS Background & Experience Care Management Company founded in 2001 Focuses on Duals, Medicaid ABD and Managing Medicaid Long term
More informationTrends in State Medicaid Programs: Emerging Models and Innovations
Trends in State Medicaid Programs: Emerging Models and Innovations Speakers: Barbara Edwards, Principal, Steve Fitton, Principal, Tina Edlund, Managing Principal, Moderator: Annie Melia, Information Services
More informationImproving Care for Dual Eligibles Opportunities for Medicare Managed Care Plans
Improving Care for Dual Eligibles Opportunities for Medicare Managed Care Plans Prepared by James M. Verdier Mathematica Policy Research for the World Congress Leadership Summit on Medicare Falls Church,
More informationNC TIDE 2016 Fall Conference November 14, Department of Health and Human Services NC Medicaid Reform Update
NC TIDE 2016 Fall Conference November 14, 2016 Department of Health and Human Services NC Medicaid Reform Update Agenda National Medicaid Landscape Medicaid Transformation in NC 1115 Waiver Process NC
More informationLong-Term Services and Supports (LTSS): Medicaid s Role and Options for States
Long-Term Services and Supports (LTSS): Medicaid s Role and Options for States Erica L. Reaves, Policy Analyst State Variation in Long-Term Services and Supports: Location, Location, Location National
More informationThe Commission on Long-Term Care: Background Behind the Mission
THE BASICS The Commission on Long-Term Care: Background Behind the Mission As part of the American Taxpayer Relief Act of 2012 (ATRA, P.L. 112-240), Congress created a Commission on Long-Term Care 1 that
More informationHealth Care Reform Provisions Affecting Older Adults and Persons with Special Needs 3/30/10
Health Care Reform Provisions Affecting Older Adults and Persons with Special Needs 3/30/10 On March 23, 2010, President Obama signed a comprehensive health care reform bill (H.R. 3590) into law. On March
More informationImproving Care and Lowering Costs for Dual Eligible Beneficiaries
Improving Care and Lowering Costs for Dual Eligible Beneficiaries An Overview of Federal and State Efforts on Duals and Suggested Strategies to Position PACE National PACE Association September 13, 2011
More informationDisability Rights California
Disability Rights California California s protection and advocacy system BAY AREA REGIONAL OFFICE 1330 Broadway, Suite 500 Oakland, CA 94612 Tel: (510) 267-1200 TTY: (800) 719-5798 Toll Free: (800) 776-5746
More informationManaged Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations
July 1, 2015 Managed Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations HealthManagement.com HealthManagement.com HealthManagement.com HealthManagement.com
More informationCOMMUNITY-BASED LONG TERM CARE PROGRAMS IN WISCONSIN. Attorney Mitchell Hagopian Disability Rights Wisconsin July 2013
COMMUNITY-BASED LONG TERM CARE PROGRAMS IN WISCONSIN I. INTRODUCTION Attorney Mitchell Hagopian Disability Rights Wisconsin July 2013 In 1981, with the creation of the Community Options Program, the state
More informationMedicaid Fundamentals. John O Brien Senior Advisor SAMHSA
Medicaid Fundamentals John O Brien Senior Advisor SAMHSA Medicaid Fundamentals Provides medical benefits to groups of low-income people with no medical insurance or inadequate medical insurance. Federally
More informationNorth Carolina Medicaid Reform
North Carolina Medicaid Reform Sandy Terrell Director, Clinical Policy Health and Human Services NC Health Care History c.1952 Good Health Act 1965 Medicare & Medicaid c.1972 Office of Rural Health 1877
More informationCoverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions
Coverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions Webinar Website: http://gucchdtacenter.georgetown.edu/resources/tawebinars.html Coverage
More informationStatewide Senior Action Conference. Mark Kissinger. Division of Long Term Care Office of Health Insurance Programs.
Statewide Senior Action Conference Mark Kissinger Division of Long Term Care Office of Health Insurance Programs October 10, 2012 Plan released on the MRT website Care Management for All is a key element
More informationAETNA MEDICAID. Respondent Demonstration to the Oklahoma Health Care Authority Care Coordination for the Aged, Blind, and Disabled.
AETNA MEDICAID Respondent Demonstration to the Oklahoma Health Care Authority Care Coordination for the Aged, Blind, and Disabled August 26, 2015 Copyright Administrators, LLC 2015 Presenters Pam Sedmak
More informationFlorida Statewide Medicaid Managed Care: Long-term Care Managed Care Program
Florida Statewide Medicaid Managed Care: Long-term Care Managed Care Program David A. Rogers Assistant Deputy Secretary for Medicaid Health Systems Agency for Health Care Administration Florida Health
More informationINTERNATIONAL MEETING: HEALTH OF PERSONS WITH ID SPONSORED BY THE CDC AND AUCD
INTERNATIONAL MEETING: HEALTH OF PERSONS WITH ID SPONSORED BY THE CDC AND AUCD Anita Yuskauskas, Ph.D. Centers for Medicare & Medicaid Services CMSO Disabled & Elderly Health Programs Group February 24,
More informationt-:-=:=.=contactd~:i~~~j ~~:~~ ~~~~~Care ====== =-=:=== --. :_=:=:== =-===: :j
Department of State Division of Publications 312 Rosa L. Parks, 8th Floor SnodgrassffN Tower Nashville, TN 37243 Phone: 615-7 41-2650 Email: publications. information@tn.gov For Department of State Use
More informationPUBLIC MEETING LONG-TERM CARE WAIVER ENROLLMENT MANAGEMENT SYSTEM (EMS) Presented by: Florida Department of Elder Affairs Staff
PUBLIC MEETING LONG-TERM CARE WAIVER ENROLLMENT MANAGEMENT SYSTEM (EMS) Rick Scott, Governor Charles T. Corley, Secretary Presented by: Florida Department of Elder Affairs Staff Introductions & Purpose
More informationThe Money Follows the Person Demonstration in Massachusetts
The Money Follows the Person Demonstration in Massachusetts Use of Concurrent 1915(b)(c) Waivers to Serve Elders and Adults with Disabilities Transitioning from Long-Stay Facilities HCBS Conference Arlington,
More informationWelcome and Introductions
Integrating Care for Dual Eligible Beneficiaries National Conference of State Legislatures Fall Forum: Changing Roles of States in Long Term Services and Supports December 3, 2013 Sarah Barth, JD www.chcs.org
More informationHHSC Value-Based Purchasing Roadmap Texas Policy Summit
HHSC Value-Based Purchasing Roadmap Texas Policy Summit Andy Vasquez, Deputy Associate Commissioner MCS, Quality & Program Improvement Section October 19, 2017 1 HHSC Value-Based Purchasing Roadmap Topics
More informationPutting the Pieces Together: Medicaid Redesign and Long Term Care
Putting the Pieces Together: Medicaid Redesign and Long Term Care Mark Kissinger, Director Division of Long Term Care Office of Health Insurance Programs New York State Department of Health NYAIL September
More informationManaged Care: We Cannot Stop the Winds of Change, but We can Direct the Sails
1 Information for Managed Care: We Cannot Stop the Winds of Change, but We can Direct the Sails Oklahoma Developmental Disabilities Services October 1, 2015 Barbara Brent, Director of State Policy on behalf
More informationCoordinating Care for Dual Eligibles: California s Demonstration Project
Coordinating Care for Dual Eligibles: California s Demonstration Project Sarah Arnquist, Harbage Consulting Alameda County Board of Supervisors Health Committee January 30, 2012 Presentation Outline Misaligned
More informationAlternative Managed Care Reimbursement Models
Alternative Managed Care Reimbursement Models David R. Swann, MA, LCSA, CCS, LPC, NCC Senior Healthcare Integration Consultant MTM Services Healthcare Reform Trends in 2015 Moving from carve out Medicaid
More informationManaged Care Transitions
Managed Care Transitions New York State Health Facilities Association Mid-Winter Education Conference Carla R. Williams, MPA Cornelius R. Murray, Esq. January 14, 2014 Medicaid Redesign Update Medicaid:
More informationQuality in Long Term Services and Supports (QuILTSS) for Nursing Facilities
TENNESSEE LTSS VBP INITIATIVES NASHP Annual Conference 2017 10/24/2017 Quality in Long Term Services and Supports (QuILTSS) for Nursing Facilities Began in 2013 with stakeholder engagement. Bridge Payment
More informationMedicaid and the. Bus Pass Problem
Medicaid and the Bus Pass Problem PRESENTED BY: Cardinal Innovations Healthcare Richard F. Topping, Chief Executive Officer Leesa Bain, Vice President, Care Coordination & Quality Management September
More informationRhode Island Real Choices Long-Term Services and Supports Resource Mapping. April 14, Ian Stockwell
Rhode Island Real Choices Long-Term Services and Supports Resource Mapping April 14, 2010 Cynthia Woodcock Ian Stockwell Aaron Tripp Overview of Presentation Resource Mapping Objectives Interviews with
More informationSTATE OF NEW JERSEY SECTION 1115 DEMONSTRATION COMPREHENSIVE WAIVER CONCEPT PAPER
STATE OF NEW JERSEY SECTION 1115 DEMONSTRATION COMPREHENSIVE WAIVER CONCEPT PAPER I. Overview of the comprehensive waiver The State of New Jersey (State), Department of Human Services (DHS), Division of
More informationHealthcare Service Delivery and Purchasing Reform in Connecticut
Healthcare Service Delivery and Purchasing Reform in Connecticut Presentation to National Association of Medicaid Directors November 9, 2011 Mark Schaefer Director, Medical Care Administration Health Purchasing
More informationFEB DEPARTMENT OF HEALTH & HUMAN SERVICES
DEPARTMENT OF HEALTH & HUMAN SERVICES FEB - 2 2016 Centers for Medicare & Medicaid Services Administrator Washington, DC 20201 Mr. Darin Gordon Director Bureau of Tenn Care Tennessee Department of Finance
More informationMedicaid Transformation
Medicaid Transformation Debra Farrington Senior Program Manager August 18, 2017 Medicaid Managed Care Already Exists in NC What North Carolina Has Now PRIMARY CARE CASE MANAGEMENT (CCNC) Primary care provider-based
More informationABC's of Managed Care and What It Might Mean for Home & Community Based Services
ABC's of Managed Care and What It Might Mean for Home & Community Based Services This project is supported by a grant from the Pennsylvania Developmental Disabilities Council. David Gates DGates@phlp.org
More informationMedicaid Transformation Overview & Update: Focus on Population Health & Diabetes
Medicaid Transformation Overview & Update: Focus on Population Health & Diabetes Kelly Crosbie, MSW, LCSW Senior Program Manager, Health Transformation June 1, 2018 2 NC MANAGED CARE OVERVIEW 3 Medicaid
More informationFlexible Accounting for Long Term Care Services: State Budgeting Practices that Increase Access to Home and Community Based Services
Flexible Accounting for Long Term Care Services: State Budgeting Practices that Increase Access to Home and Community Based Services Recommendations for California By Leslie Hendrickson, Ph.D. Laurel Mildred,
More informationImproving Service Delivery for Medicaid Clients Through Data Integration and Predictive Modeling
Improving Service Delivery for Medicaid Clients Through Data Integration and Predictive Modeling Getty Images David Mancuso, PhD July 28, 2015 1 The Medicaid Environment Program costs are often driven
More informationAdult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives
Adult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives April 30, 2018 2 Agenda for the Day Vision and Overview: HARP and BH HCBS Recovery Coordination
More informationMedicaid Coverage of Long-Term Services and Supports
Medicaid Coverage of Long-Term Services and Supports Kirsten J. Colello Specialist in Health and Aging Policy December 5, 2013 Congressional Research Service 7-5700 www.crs.gov R43328 Summary Long-term
More informationSubtitle E New Options for States to Provide Long-Term Services and Supports
LONG TERM CARE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care and Education
More information